Provider Demographics
NPI:1427342260
Name:BUCKS COUNTY INTERNAL MEDICINE PC
Entity type:Organization
Organization Name:BUCKS COUNTY INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GIACOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGIARACINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-462-7790
Mailing Address - Street 1:1415 HEATHER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3731
Mailing Address - Country:US
Mailing Address - Phone:609-462-7790
Mailing Address - Fax:215-550-6154
Practice Address - Street 1:1415 HEATHER RIDGE DR
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:609-462-7790
Practice Address - Fax:215-550-6154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05739000207R00000X
PAMD44780L207R00000X
208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty